The Fund provides continuation of coverage on a voluntary basis similar to those provided under the Federal law known as COBRA. This allows you and your dependents to temporarily receive benefits from the Fund under certain circumstances, known as "qualifying events", when plan coverage would otherwise terminate. You and/or your dependents must pay the full Continuation Coverage premium. You will be provided with monthly cost information if you become eligible for Continuation Coverage. The benefits which you and/or your dependents receive will be identical to those received by active Fund members.

• How do I become eligible for Continuation Coverage?
  
• How long does my Continuation Coverage last?
  
• How do I apply for Continuation Coverage?

This is intended to be a general, informational discussion of your rights under the Continuation Coverage program. If you have any questions regarding your eligibility for Continuation Coverage, please contact the MPE Fund Office at (800) 325-5214.

How do I become eligible for Continuation Coverage?

As an employee, you have the right to purchase Continuation Coverage from the Fund if:

• your employment terminates (either voluntarily or involuntarily)
  for any reason other than gross misconduct; or
  
• your hours are reduced to less than the minimum required for eligibility; or
  
• you are on an employer-approved leave.
  

Your spouse has the right to purchase Continuation Coverage if:

• your employment terminates (either voluntarily or involuntarily)
  for any reason other than gross misconduct; or
  
• your hours are reduced to less than the minimum required for eligibility; or
  
• you are on an employer-approved leave; or
  
• you die while participating in the plan; or
  
• you become entitled to Medicare benefits following the election of Continuation Coverage; or
  
• you are divorced or legally separated
  and a judgement has been granted terminating your spouse’s eligibility; or
  
• you or your ex-spouse remarries within 36 months of your divorce,
  providing the ex-spouse was eligible on the date of remarriage.

Your dependent children have the right to purchase Continuation Coverage if:

• your employment terminates (either voluntarily or involuntarily)
  for any reason other than gross misconduct; or
  
• your hours are reduced to less than the minimum required for eligibility; or
  
• you are on an employer- approved leave; or
  
• you die while participating in the plan; or
  
• you become entitled to Medicare benefits following the election of Continuation Coverage; or
  
• your dependent child ceases to meet the definition of “dependent child” used by the Fund.
  

You, your spouse or your dependent children must notify the Fund in the event of a divorce, remarriage or change in dependent status. The Fund must receive this notification within 60 days of the date on which coverage would terminate as a result of the qualifying event.

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How long does my Continuation Coverage last?

Continuation Coverage benefits are temporary. If you, your spouse or your dependent children become eligible for Continuation Coverage due to the termination (either voluntary or involuntary) of your employment, a reduction in your hours or your being on an employer-approved leave, Continuation Coverage may continue for up to 18 months. If your spouse and/or your dependent children become eligible for Continuation Coverage due to your death, your entitlement to Medicare benefits, the loss of dependent status, your divorce or the remarriage of you or your ex-spouse, they may be eligible for up to 36 months of coverage. Any individual (either a member or a dependent of a member) who loses dental and vision benefits with the Fund due to the member's termination from employment or reduction in hours is eligible for up to 29 months of Continuation Coverage if that individual is determined by the Social Security Administration :

1. to have been disabled at the time of the qualifying event for loss of coverage, or
   
2. to have become disabled during the first 60 days of Continuation Coverage.

In each case, the individual must notify the Fund within 60 days of the determination and before the end of the original 18 month Continuation Coverage period. This 11 month extension of the usual 18 month Continuation Coverage period is available to all the qualified beneficiaries covered on the Continuation Coverage plan from the date of the qualifying event.

You, your spouse or your dependent children will lose Continuation Coverage if:

• the Fund no longer provides benefits; or
  
• you, your spouse or your dependent children fail to promptly pay the monthly
  Continuation Coverage premium.Continuation Coverage payments are due on the first day of the month prior the coverage month (e.g. payment for coverage for the month of July is due June 1st). Failure to pay your monthly Continuation Coverage premium by the due date will result in a permanent loss of coverage; or
  
• you, your spouse or your dependent children become covered under any other group plan which provides the same benefits offered by this plan (e.g. you
  transfer to a management position and are covered by the Group Insurance
  Commission dental plan; you transfer to a position in another Bargaining Unit which offers dental benefits; or you begin a new job which offers a plan with
  similar benefits); or
  
• you, your spouse or your dependent children become entitled to Medicare
  benefits following the election of Continuation Coverage; or
  
• in the case of 29 months of Continuation Coverage, the qualified beneficiary
  ceases to be disabled as defined by the Social Security Administration. The
  Fund must be notified of this cessation of disabled status within 30 days of the
  determination.

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How do I apply for Continuation Coverage?

Your employer must notify the Fund within 30 days of your termination from employment, reduction in hours or your death. Once the Fund receives this information an election form and notice of your Continuation Coverage rights will be mailed to the address on file with the Fund. It is your responsibility to maintain an accurate address on file with the Fund. If you do not receive notification and believe you are eligible for Continuation Coverage, you must call the Fund immediately. If you do not apply for Continuation Coverage within 60 days of the date on which the notification was sent by the Fund, you will lose your Continuation Coverage eligibility.

You, your spouse or your dependent children must notify the Fund in the event of a divorce, remarriage or change in dependent status. Once notified, the Fund will send a notice asking your spouse and/or your dependent children if they wish to purchase Continuation Coverage. If the Fund is not notified within 60 days of the date on which coverage would terminate as a result of the qualifying event, your spouse and dependent children will lose their Continuation Coverage eligibility.

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